COVID-19 Guidelines and Waiver

Athlete Information

Student's Name

First NameLast Name

Phone Number

Area CodePhone Number

Student Date Of Birth:

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information (if athlete is under 18)

Name

First NameLast Name

Mobile Number

eg 021Phone Number

E-mail

example@example.com

COVID-19 Rules and CONSENT FORM FOR Martial ARTS TRAINING AT THE SENTOU DOJO
You as a parent or student hereby agree that to participate in training at the Sentou Dojo Martial Arts School. You understand that there are risks
associated with either my child or my participation and I fully accept and release the owner and the staff, their heirs and anyone connected with the Sentou Dojo from any responsibility related to any likelihood of contracting COVID-19 during training. I fully confirm that I have not tested positive for COVID-19 nor do I have any symptoms currently related to COVID-19.

I am also truthfully stating that I have not had any contact with anyone who may have any symptoms concurrent with COVID-19, including but not limited to to fever, cough, nausea, diarrhea, vomiting, shortness of breath, etc. If I develop symptoms, I will immediately notify the staff and discontinue classes until such time as medically cleared by a physician to do so. I will fill out the COVID-19 form and sign it for myself or my child upon my first visit to the training center and will be asked to update any changes in information of medical status. I and or my children agree to follow the safety protocols listed on this document in order to train at the Sentou Dojo.

* Please do not participate or show up for class if you are feeling ill or having symptoms of any kind.
* Temperature's will be checked upon entering the dojo.
* Wash hands or use hand sanitizer when entering and exiting the training facility.
* Proper protective mask must be worn at all times. (mask will be available if needed.
* Social Distancing must be followed at all times. (6 Feet apart from the nearest person)
* No physical contact unless you consent to waive the social distance policy.
* The training area will be disinfected and sanitized after each use. *We will make every effort to provide for the health and safety of our students.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Student signature:

Parent or Guardian signature: blanks

Date

Sentou Dojo Enrollment and COVID-19 Guidelines Form